Insurance World

About 87 percent of the residents of Germany have statutory health insurance, i.e. GKV. As of May 2005, the GKV relied on 321 non-profit sickness funds to collect premiums from their members and pay health care providers according to negotiated agreements. Those who are not insured this way, mainly civil servants and the self-employed, receive health care through private for-profit insurance.

An estimate of 0,3 percent of the German population (around 250,000 people) has no health insurance at all. Some of them are so rich that they do not need it but most of them are poor and receive health care through social assistance.

Germany’s statutory health insurance

There are three different categories of sickness funds: primary funds, substitute funds and “special” funds. Some workers are required to be members of the primary funds, e.g. if they earn less than the than the income ceiling (2006: EUR 3,937.50 per month / EUR 47,250.00 per year). Those earning more than that ceiling may be members on a voluntary basis, or they may have a choice of funds. Some of them automatically become members of a particular fund for example because of their occupation (company-based funds) or place of residence (local sickness funds). Some occupations have their own “special” funds, e.g. farmers or sailors.

Substitute funds are divided into two kinds: they provide health insurance to both white collar workers and blue collar workers earning more than the income ceiling. Membership is voluntary.

Both, employers and employees pay half of a member’s premiums, which in 2006 averaged between 13 and 14 percent of a worker’s gross earnings up to the contribution assessment ceiling (2006: EUR 3,562.50 monthly / EUR 42,750.00 p.a.). Premiums are fixed according to earnings rather than risk and are unaffected by the respective member’s marital status, family size, or health. Premiums are the same for all members within a particular fund with the same earnings.

Germany’s private health insurance

About eleven percent of Germany’s residents pay for private health insurance provided by some 40 for-profit insurance carriers. Many of those choosing private insurance are civil servants who want to secure percentage of their medical bills not covered by the government. Some sickness-fund members buy additional private insurance to cover such extras as a private room or a choice of physicians while in a hospital. Otherwise, the medical care provided to the publicly and privately insured is identical. In both cases the same medical facilities are used. Self-employed persons earning above the income ceiling must have private insurance. Members of a sickness fund who leave it for a private insurance carrier are not allowed to return to public insurance.

As opposed to the statutory heath insurance, contributions to the private insurance depend on the member’s age, gender, occupation and health status, that is, the individual risk. Although private insurance companies pay health care providers about twice the amount paid by the primary sickness funds, private insurance is often cheaper than statutory health insurance, especially for younger policyholders without dependents. As is the case for members of sickness funds, employees who have private insurance have half their premiums paid by their employers.

Copyright 2006 Clay Cotton

When you consider a life long relationship with a Long Term Care Insurance company, you want to rest in the comfort of knowing that you have settled on a company with the highest possible ratings and reputation. After all, you will need them to be there for you in a pinch when you need to file a claim for the specified benefits.

With a serious relationship like long term care insurance, reliability is really, really important, don’t you agree? So our topic today is how to check out a the long term care insurance company to make sure that they meet the highest standards.

In my opinion, the safest thing to do is to work directly with the long term care insurance Buyer’s Advocate, because you can be assured that only top companies and policies will be considered.

In any case, over ten years as an observer of the long term care insurance marketplace, I’m not aware of even one case of fraudulent behavior by an insurance company.

Still, it makes good sense to check into a long term care insurance company’s market behavior, history, ratings, consumer confidence and their records with state regulatory agencies.

1. Call your State Department of Insurance.

2. Ask for Consumer Assistance.

3. Request data on long term care insurance companies, then for each carrier you are interested in, ask for the company’s “Annual Sales Figures for long term care insurance”. Also get the total number of Complaints for both Facility Coverage and for Home Care Coverage. Then ask for their total “Long term care insurance Complaints Ratio” or “Long term care insurance Complaints per Million”. Compare this for several companies to get a feel for consumer confidence.

4. Have your long term care insurance agent obtain in writing the company’s current A.M. Best Rating. It must be A- or above. Accept no B+ or lower ratings unless you have health conditions which prevent coverage with a higher rated company.

5. If you are really serious, you can visit the Department of Insurance in person, and ask to see the “Rate Logs” to determine how many times, if any, a company has raised rates on any group of long term care insurance poicyholders in your state. A history of multiple rate increases over more than a few years would be a red flag.

6. Go to the Public Library - Ask reference desk for insurance rating books, specifically ones like A.M. Best, Weiss Research, S&P, Moody’s, etc.

Do this before you make your commitment to one company or another. Sure, it’s a little work, but you and your family will depend on this long term care insurance company in the caregiving years, and that Is a time when you want to minimize hassles. You’ll be glad you did.